Afterschool Program
Registration

Fill out the form below and we'll be in touch soon
to confirm your child's spot.

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You're all set!

Thanks for registering! We've received your information and will be in touch at the email address you provided.

Child Information

First Name

Last Name

School

Rising Grade

Enrollment Schedule

Preferred Days (select all that apply)

⚠️ Wednesday enrollment requires a schedule of 2 or more days per week. Please select an additional day or choose a different enrollment schedule.

Parent / Guardian Information

Parent / Guardian Name

Phone Number

Email Address

Comments or Questions (optional)

All fields required unless marked optional.